4 Types of Services
(GAPS)

Health care (3)

Health guidance (7)

Screening (13)

Immunizations (1)

13 Topics/Health Conditions

Parents ability to cope

Adolescent adjustment

Safety & injury prevention

Physical fitness

Diet

Psychosexual development

Hypertension

High cholesterol

Tobacco

Alcohol & other drugs

Depression & suicide

Abuse

Learning problems

Infectious diseases

Comprehensive School-Based Health Centers

Brief History

School-based Health Centers established in 1970

200 in 1990

1,380 in 2000

all regions of U.S.; all types of schools

only Idaho, Nevada, North & South Dakota, and Wyoming report no SBHC

Location of SBHC’s by Region
158 SBHC’s in NYS; 98 in NYC

Location of SBHC’s by Region

Types of schools housing SBHC’s

Comprehensive Services

To ensure comprehensive health services, SBHCs led by a community health-care institution

Three-quarters of SBHCs administered by community health center, health department, or hospital

CHEP School-Based Health Centers

I.S. 164 (1986)

I.S. 52 (1986)

I.S. 143 (1989)

I.S. 136 (1990), now TMA/B&R

George Washington High School (1995)

High School for Pregnant Teens (1998)

Family Academy (2002)

Slide 15

Staffing

SBHC Services

Medical

Mental Health

Health Education

Social Work/Support

In Your Face (Tiezzi)

Group and individual counseling in the SBHC

Classroom education

Intensive case management and case finding

Referrals to YMC and YAC

STD prevention services

HIV pre & post-test counseling and testing

Evaluation

Pregnancy rates among teens younger than 15 decreased by 34% over four years

In the fourth year of the program, the pregnancy rate in one school that was unable to continue IYF had three times the rate of pregnancy as three program schools (16.5 per 1,000 female students versus 5.8 per 1,000)

CHEP SBHC Funding

School Enrollment & Clinic Consents

Screening Survey:

administered school-wide risk screening survey to identify students who might otherwise not utilize health services

Results

Fall 1997, over 2,200 7th and 8th graders surveyed:

3% cigarettes every day

2% alcohol every day

13% sex

2% tried suicide

15% easy to buy gun

"6%"

6% adult in home use substances

13% > 1 fight in past 3 months

12% “Hooky Party” in past year

38% something happen makes them feel terrible when think about it

16% to a Botanica

Slide 25

Leading Causes of Mortality, Ages 15-19, 2000

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

“Male Adolescent Use of Health Care Services: Where Are the Boys?”
Arik Marcell, etal. Jnl of Adolescent Health, 2002: 30

Secondary analysis of NAMCS, NHAMCS, CAHSS

13-19 males make fewer visits to adolescent health programs (schools, hospitals, community health centers)

Of all adolescent health clinic venues, SBCs see highest proportion of males (40% vs. 60%)

DHHS Office of Family Planning

Slide 36

Slide 37

Slide 38

After-school
Tournament

Slide 40

Slide 41

Slide 42

There are many reasons…

Risky behaviors

Unhealthy environments

Not enough health services

Other ideas?

Clinic-based Activities

Comprehensive intake assessment

Small groups

Case management of high risk

Referrals

Slide 45

Slide 46


	Health care (3)
	Health guidance (7)
	Screening (13)
	Immunizations (1)


	Parents ability to cope
	Adolescent adjustment
	Safety & injury prevention
	Physical fitness
	Diet
	Psychosexual development
	Hypertension
	High cholesterol
	Tobacco
	Alcohol & other drugs
	Depression & suicide
	Abuse
	Learning problems
	Infectious diseases


	School-based Health Centers established in 1970
	200 in 1990
	1,380 in 2000
	all regions of U.S.; all types of schools
	only Idaho, Nevada, North & South Dakota, and Wyoming report no SBHC


	To ensure comprehensive health services, SBHCs led by a community health-care institution
	Three-quarters of SBHCs administered by community health center, health department, or hospital


	I.S. 164 (1986)
	I.S. 52 (1986)
	I.S. 143 (1989)
	I.S. 136 (1990), now TMA/B&R
	George Washington High School (1995)
	High School for Pregnant Teens (1998)
	Family Academy (2002)


			Group and individual counseling in the SBHC
			Classroom education
			Intensive case management and case finding
			Referrals to YMC and YAC
			STD prevention services
			HIV pre & post-test counseling and testing


	Pregnancy rates among teens younger than 15 decreased by 34% over four years
	In the fourth year of the program, the pregnancy rate in one school that was unable to continue IYF had three times the rate of pregnancy as three program schools (16.5 per 1,000 female students versus 5.8 per 1,000)


	administered school-wide risk screening survey to identify students who might otherwise not utilize health services


	Fall 1997, over 2,200 7th and 8th graders surveyed:
		3% cigarettes every day
		2% alcohol every day
		13% sex
		2% tried suicide
		15% easy to buy gun


		6% adult in home use substances
		13% > 1 fight in past 3 months
		12% “Hooky Party” in past year
		38% something happen makes them feel terrible when think about it
		16% to a Botanica


	Secondary analysis of NAMCS, NHAMCS, CAHSS
	13-19 males make fewer visits to adolescent health programs (schools, hospitals, community health centers)
	Of all adolescent health clinic venues, SBCs see highest proportion of males (40% vs. 60%)


	Risky behaviors
	Unhealthy environments
	Not enough health services
	Other ideas?


	Comprehensive intake assessment
	Small groups
	Case management of high risk
	Referrals